Related Experiment Videos
[Evaluation of a new preservation solution for hypothermic heart transplant]
1Unité de recherche INSERM-U121, 22, avenue du Doyen Lépine, 69675 Bron, France.
Insights
A new cardiac preservation solution (NS) demonstrated optimal myocardial preservation in hypothermic rat hearts, significantly outperforming University of Wisconsin (UW-1, UW-2) and Saint-Thomas
Area of Science:
- Cardiology
- Transplantation Biology
- Biomedical Engineering
Background:
- Limited cardiac preservation time (4-6 hours) is a major challenge in heart transplantation, restricting donor pool access and long-distance organ transfer.
- Various cardiac preservation solutions have been developed, but no consensus exists on the optimal formulation for extending myocardial viability.
- Developing effective preservation solutions is crucial for improving heart transplant outcomes and logistical capabilities.
Purpose of the Study:
- To evaluate the efficacy of several cardiac preservation solutions in maintaining myocardial quality.
- To compare a novel solution (NS) against established solutions like University of Wisconsin (UW-1, UW-2) and Saint-Thomas' Hospital (STH-1).
- To determine the optimal solution for extended hypothermic preservation of isolated rat hearts.
Main Methods:
- Sixty male Wistar rats were used, with hearts randomized into six groups (NS, STH-1, UW-1, UW-2, NaCl, controls).
- Hearts were preserved by immersion for 8 hours at 4°C in the respective solutions.
- Functional assessment via Langendorff reperfusion and energetic assessment via freezing were performed.
Main Results:
- The NS solution group exhibited superior ventricular function and energetic charge compared to NaCl, STH-1, UW-1, and UW-2 groups.
- NaCl-treated hearts showed severe arrhythmia and collapsed left ventricular pressure.
- UW-2 hearts had a significantly lower energetic charge, while STH-1 and NaCl groups showed elevated creatine kinase levels.
Conclusions:
- The composition of cardiac preservation solutions significantly impacts myocardial preservation quality.
- The novel NS solution proved optimal for preserving isolated hypothermic rat hearts in this study.
- These findings suggest NS holds promise for extending cardiac preservation times in transplantation.
Aim:
One of the major problems encountered in heart transplant is the limited cardiac preservation time. The time limit from the moment the donor heart is removed to the transplant itself is 4-6 hours at maximum. Extending the preservation time would therefore provide access to a larger pool of donors, and also permit long-distance (transfrontier) organ transfer. To attain this aim, a number of different cardiac preservation solutions have been proposed and evaluated either clinically or experimentally; however, no consensus has yet been reached by the various heart transplant teams involved. As finding an optimal solution is of major importance, the aim of the present study was therefore to assess the efficacy of several cardiac preservation solutions: the University of Wisconsin solutions (UW-1 and UW-1 + calcium = UW-2), the Saint-Thomas' Hospital solution (STH-1) and a new solution (NS) developed by our laboratory.
Method:
Male Wistar rats (n = 60) were anesthetized by i.m. injection of pentobarbitol, and randomized into six groups, i.e., NS (group I), STH-1 (group II), UW-1 (group III), UW-2 (group IV), saline solution, NaCl (group V), and controls (group VI). All the hearts except those in the control group were preserved by immersion (8 hours, 4 degrees C) in the different solutions (n = 10/group). The hearts were either a) reperfused in Langendorff mode (functional assessment, n = 5/group); or b) frozen (energetic assessment, n = 5/group).
Results:
The hearts treated with NaCl displayed arrhythmia and a collapsed mean left ventricular pressure throughout the reperfusion period (3.6 +/- 1.3 mmHg) compared to the NS hearts and the control group (97 +/- 2.6 and 122 +/- 1.9 respectively), while the STH-1, UW-1 and UW-2 hearts showed an intermediate-range ventricular function (48 +/- 4; 39.9 +/- 4.1; and 69 +/- 1.8 respectively). Creatine kinase levels were higher in the STH-1 and NaCl groups (541.9 +/- 168 and 1,080.8 +/- 126.2 IU/L respectively). The energetic charge was significantly lower in the NaCl and UW-2 groups (P = 0.001) compared to the control, NS, STH-1 and UW-1 groups.
Conclusion:
It was found that the composition of the respective solutions had a major effect on the the quality of myocardial preservation. Compared to the other solutions tested in this study, the NS solution was found to be optimal for the preservation of isolated hypothermic rat hearts.